COVENANT HOME HEALTH CARE 4, LLC (NPI# 1902458722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902458722 |
| Entity Type | Organization |
| Organization Name | COVENANT HOME HEALTH CARE 4, LLC |
| Practice Address |
3636 University Blvd S Jacksonville FL 32216-4250 |
| Mailing Address |
5041 N 12th Ave Pensacola FL 32504-8916 |
| Practice Telephone | 8504332155 |
| Mailing Telephone | 8504332155 |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-07-11 |
| Authorized Official Name | THOMAS FRANKLIN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 8504332155 |
| Is Organization Subpart | Y |
| Parent Organization Name | COVENANT HEALTH AND COMMUNITY SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Street Address |
3636 UNIVERSITY BLVD S |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-4250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023016987 | Samuel D Kulick | Podiatrist | 3636 University Blvd S, Bldg C, Jacksonville, FL 32216-4250 | 2005-07-13 |
| 1801379409 | Bellavista Dermatology Group LLC | Dermatology | 3636 University Blvd S, Unit B2, Jacksonville, FL 32216 | 2018-09-10 |
| 1639528532 | Precision Eyewear of Wolchok Eye, LLC | Eyewear Supplier (Equipment, not the service) | 3636 University Blvd S, Suite A2, Jacksonville, FL 32216-4250 | 2016-06-10 |
| 1619371465 | Swapnilkumar P Patel | Podiatrist | 3636 University Blvd S, Bldg C, Jacksonville, FL 32216-4250 | 2014-10-22 |
| 1780958314 | Indian Rehabilitation Center, Inc | Clinic/Center | 3636 University Blvd S, Ste A7, Jacksonville, FL 32216-4250 | 2012-02-29 |
| 1689942302 | Adler Podiatry Clinic Pllc | Podiatrist | 3636 University Blvd S, Bldg C, Jacksonville, FL 32216-4250 | 2011-12-08 |
| 1255567301 | Adler Podiatry and Wound Care LLC | Podiatrist | 3636 University Blvd S, Bldg C, Jacksonville, FL 32216-4250 | 2009-06-03 |
| 1356503007 | Osvaldo Contarini Md Pa | Surgery | 3636 University Blvd S, Bldg B, Jacksonville, FL 32216-4250 | 2008-06-25 |
| 1558491258 | Myron F Mass Md Pa | Allergy & Immunology | 3636 University Blvd S, Suite B-2, Jacksonville, FL 32216-4250 | 2007-03-06 |
| 1740324102 | Stephen Mark Wolchok | Ophthalmology | 3636 University Blvd S, A2, Jacksonville, FL 32216-4250 | 2007-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850185 | Latoya Butler | Home Health | 5710 Lenox Ave Apt 121, Jacksonville, FL 32205-6383 | 2020-10-30 |
| 1871193334 | All Executive Healthcare Agency LLC | Home Health | 841 Prudential Dr Ste 1211, Jacksonville, FL 32207-8329 | 2020-10-26 |
| 1013516335 | Melissa Horne | Home Health | 2426 Lotus Rd E, Jacksonville, FL 32211-4169 | 2020-10-19 |
| 1114525821 | Sep Companion Services | Home Health | 1979 Lane Ave S, Jacksonville, FL 32210-2741 | 2020-10-14 |
| 1235737925 | Concierge Home Care of Jacksonville 2, LLC | Home Health | 4655 Salisbury Rd Ste 110, Jacksonville, FL 32256-0957 | 2020-10-14 |
| 1821696808 | Above and Beyond Solutions LLC | Home Health | 8030 Loch Lomond Ln, Jacksonville, FL 32244-5519 | 2020-10-13 |
| 1891302386 | Deanna Domineck | Home Health | 913 Lord Nelson Blvd, Jacksonville, FL 32218-6755 | 2020-09-28 |
| 1861009359 | A Serene Services LLC | Home Health | 8553 Argyle Business Loop Ste 5e, Jacksonville, FL 32244-6604 | 2020-09-28 |
| 1770199317 | Alpha 1st Home Health Care | Home Health | 1619 Nottingham Knoll Dr, Jacksonville, FL 32225-2665 | 2020-09-18 |
| 1255944682 | Life Assistance and Management Agency | Home Health | 7606 Tarleton Rd, Jacksonville, FL 32208-3433 | 2020-08-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.